Hospital acquired infections (HAI) are the 4th leading cause of death in the United States, and claims 15,000 lives annually in Europe. One of the major sources of HAI is the improper hand disinfection of the medical staff. HAI (also called nosocomial infections) generate unnecessary expenses, and also reduces the quality of life of the patients. It prolongs recovery and promotes the resistance of pathogens against antibiotics.
The applied methods of hand disinfection have been widely discussed in recent studies such as in BERHE M., EDMOND M. and BEARMAN G., “Measurement and feedback of infection control process measures in the intensive care unit: impact on compliance”, Amer. J. Infection Contr., vol. 34, no. 8, 2006, pp. 537-539. and in ROSENTHAL V., GUZMAN S. and SAFDAR N., “Reduction in nosocomial infection with improved hand hygiene in intensive care units of a tertiary care hospital in Argentina”, Amer. J. Infection Contr., vol. 33, no. 7, 2005, pp. 392-397. These processes are now regulated by European and U.S. standards such as reported by GORONCY-BERMES P., “Hand disinfection according to the European Standard EN 1500 (hygienic handrub): a study with Gram-negative and Gram-positive test organisms”. Int. J. Hyg. Environ. Health vol. 204, 2001, pp. 123-126. and by BOYCE J. M. and PITTET D., “Guideline for hand hygiene in healthcare settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force”, Morbidity and Mortality Weekly Report, vol. 51, no. 16, 2002, pp. 1-45. Despite the numerous automated disinfection stations and the spread of antibacterial soaps, the insufficient hand washing remains a major problem in health care and causes several infection-related problems at general households as well. In the medical environment, appropriate hand disinfection is required to keep HAI rates low, especially as the new mutant germs—such as the NDM-1—show high resistance to antibiotic treatment. In general practice however, proper hand hygiene helps to maintain a healthy life, and to prevent or reduce the spread of epidemics (SARS, H1N1 and so).
In 2009, the health care costs directly related to HAIs were about 40 billion dollars in the U.S. and it is increasing each year, causing permanent damage and even death in the most serious cases. It has been shown that at least 30% of these infections could be prevented as reported by KAMPF G, “The six golden rules to improve compliance in hand hygiene”, Archives Journal of Hospital Infection, Volume 56, Supplement 2, April 2004, pp. 3-5 and by PITTET D., MOUROUGA P et al., “Compliance with handwashing in a teaching hospital”, Ann Inter Med. 2002, pp. 126-130. The fight against HAI begins at the medical workers' hand hygiene. A major study by the Association for Professionals in Infection Control and Epidemiology, Inc. et al., “Measuring hand hygiene adherence: Overcoming the challenges”. WHO Report, 2009 (http://www.jointcommission.org/NR/rdonlyres/68B9CB2F-789F-49DB-9E3F-2FB387666BCC/0/hh_monograph.pdf) concluded, based on 96 publications addressing hand hygiene, that overall hand hygiene adherence rate is 40 percent among health care workers.
Up to now, there have only been limited solutions developed to support health care institutes with technology-aided quality control of hand disinfection. Ultraviolet reflective gels are available to simulate germs, and to demonstrate proper hand washing by removing the reflective material, which is known as Glo Germ Medium Powder Kits (http://www.sellesmedical.co.uk/store/product/3262-Glo-Germ-Medium-Powder-Kits). Ultraviolet light is used in general cleaning (U.S. Pat. No. 7,718,395) to spot for urine and phosphate particles especially. Occasionally, hand washing quality is checked under UV lighting, but only verified by the naked eye, and performed for marketing purposes (U.S. Pat. Nos. 6,524,390, 5,900,067). Most systems are available to track to spatial motion of the medical staff, and record the time they spend e.g. in the sanitary station (U.S. Pat. Nos. 7,443,305, 7,616,122) or the use of the disinfection gels (U.S. Pat. No. 6,392,546). Software solutions did get developed to support the registration of hand washing events (e.g. iScrub Lite iPhone and iPad app, https://compepi.cs.uiowa.edu/iscrub/home/), however, these require manual data input. The only device that tries to verify the disinfection is the Hygreen system from Xhale tech. Inc. (U.S. Pat. Nos. 7,755,494, and 7,551,092) also published on Internet (www.xhale.com/hygreen/), but it is only capable of determining the presence of alcohol scent on the hand (U.S. Pat. No. 7,755,494) that is absolutely no guarantee for adequate disinfection. Similar solutions have been developed for general cleaning verification in the food industry (U.S. Pat. No. 6,038,331), relying on colored soap detection on the hand or other surfaces.